应用Robson十分类法分析某医院2016年和2017年剖宫产率

Analysis of Cesarean Section Rate in 2016 and 2017 in a Hospital by Robson Ten Group Classification

目的为探索降低剖宫产率的途径和方法,研究引起剖宫产率升高产妇人群的各种类型,对某医院2016年和2017年剖宫产情况进行比较分析。方法首先对2016年和2017年在某院分娩的32361例和10 804例产妇,按照Robson十分类法进行了分组,找出对总剖宫产率影响较大的产妇组群,用χ~2检验比较两年间各组产妇人数的变化和剖宫产率的变化以及对总剖宫产率影响的变化。结果 2016年和2017年该院的总剖宫产率分别为23.97%和34.16%。2017年比2016年略有升高。第1组(单胎、头位、初产妇、足月、自然分娩)和第2组(单胎、头位、初产妇、足月、临床引产或产前剖宫产)产妇人数最多,分别排第1位和第2位。和2016年比较,2017年这两组产妇人数有所减少,但经产妇组人群,即第3组(单胎、头位、经产妇、足月、自然分娩),第4组(单胎、头位、经产妇、足月、临床引产或产前剖宫产)和第5组(单胎、头位、足月、有剖宫产史)人数却都有增加。特别需要指出的是,到2017年第5组对总剖宫产率的影响已经超过了第2b组,变成了对总剖宫产率影响最大的一个组群。结论 Robson十分类法是一种分析剖宫产率及其随时间变化趋势准确而有效的工具,可用在控制和降低剖宫产率的工作中。

Objective To explore the way and method of reduction of the cesarean section rate(CS rate),comparative analysis of the cesarean section situation of a hospital in 2016 and 2017 was carried out. Methods Toidentifywhichtypes of delivery women could be defined as the major contributor to the rise of the total CS rate,a total of the 32361 and 10824 cases of pregnant women, having birth of babies in the hospital in 2016 and 2017 respectively, was been classified in accordance with the Robson Ten Group Classification System first, and then regression analysis was applied for them. To determine the variation of delivery women in total, and their distribution in every group during the two years, the ch-square test was applied to the data also. Results It is found that the total CS rate in the analyzed hospital are 23.97% and 34.16% in 2016 and 2017 respectively. And a slight rising in 2017 was observed. The Group one(singleton, cephalic, nullparous, term and spontaneous) and Group two(singleton, cephalic, nullparous, term but inducedlabor or CS before delivery) were most populated and ranked the first and the second respectively. In contrast with 2016, Group one and Group two showed a slightly lessened,and Group 3(singleton, cephalic, multilparous, term and spontaneous), Group four(singleton,cephalic,multiparous, term but induced labor or CS before delivery) Group five(singleton,cerphalic, termwith CS history)was enlarges in 2017. And the Group two and Group five have a most contribution to the total CS rate, especially Group five, till 2017 its contribution on the total CR rate has overtook and exceeded that of the Group two, and became the first powerful contributor to the CS rate. Conclusion Robson Ten Group Classification System is an exact and effective tools to study the CS rare and its varying with time, and could be used in the control and reduction of the CS rate.